If You Change the Way You Look at Things, Things You Look at Change. Max Planck’s Challenge for Health, Health Care, and the Healthcare System

Sturmberg, Joachim P.

doi:10.1007/978-3-030-10940-0_1

Cited by 6 publications

(6 citation statements)

References 133 publications

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“…11 , 12 It further includes work within the primary care sciences that has compellingly adapted the principles of complexity theory to health and to multimorbidity specifically. 9 , 86 This is not to mention the vast local knowledge, expertise, and experience that does not make into peer-reviewed journals and is often bypassed in the design of interventions. Folding complexity and context-sensitivity into our framing of multimorbidity presents an opportunity to bring together disciplines, fields, and perspectives both within and beyond biomedicine in novel and potentially unexpected configurations to articulate and respond to people’s needs.…”

Section: Reframing Multimorbidity In Global Healthmentioning

confidence: 99%

Making morbidity multiple: History, legacies, and possibilities for global health

Dixon

Mendenhall

Bosire

et al. 2023

Journal of Multimorbidity and Comorbidity

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Multimorbidity has been framed as a pressing global health challenge that exposes the limits of systems organised around single diseases. This article seeks to expand and strengthen current thinking around multimorbidity by analysing its construction within the field of global health. We suggest that the significance of multimorbidity lies not only in challenging divisions between disease categories but also in what it reveals about the culture and history of transnational biomedicine. Drawing on social research from sub-Saharan Africa to ground our arguments, we begin by describing the historical processes through which morbidity was made divisible in biomedicine and how the single disease became integral not only to disease control but to the extension of biopolitical power. Multimorbidity, we observe, is hoped to challenge single disease approaches but is assembled from the same problematic, historically-loaded categories that it exposes as breaking down. Next, we highlight the consequences of such classificatory legacies in everyday lives and suggest why frameworks and interventions to integrate care have tended to have limited traction in practice. Finally, we argue that efforts to align priorities and disciplines around a standardised biomedical definition of multimorbidity risks retracing the same steps. We call for transdisciplinary work across the field of global health around a more holistic, reflexive understanding of multimorbidity that foregrounds the culture and history of translocated biomedicine, the intractability of single disease thinking, and its often-adverse consequences in local worlds. We outline key domains within the architecture of global health where transformation is needed, including care delivery, medical training, the organisation of knowledge and expertise, global governance, and financing.

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Section: Reframing Multimorbidity In Global Healthmentioning

confidence: 99%

Making morbidity multiple: History, legacies, and possibilities for global health

Dixon

Mendenhall

Bosire

et al. 2023

Journal of Multimorbidity and Comorbidity

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“…11,12 The key point here is that health is a personal and adaptive state arising from interactions between ones somatic, emotional, social and sensemaking domains (SPSS-model of health)-the presence or absence of a good health experience can emerge as much in the presence as absence of 'identifiable disease' or a 'vaguely defined diagnosis'. 27 A systemic picture of patient-orientation in health care has the patient at its centre, 'sandwiched' between the contextual domains of the macro-level socio-environmental and the detailed domains of the micro/nano-level of physiology and genomics. 15,28 Again, the details have been described elsewhere and are summarised in Figure 2.…”

Section: Complexity-understanding the Wholementioning

confidence: 99%

“…Turcotte et al's 1 call for change should have gone much further and have embraced Max Planck's challenge: ‘ If you change the way you look at things, things you look at change ’. If one looks through a complexity lens at patient‐orientation one would indeed see that things change, and change dramatically 27 …”

Section: A Call To Embrace a Complexity Paradigm For Health Care Deli...mentioning

confidence: 99%

Changing the paradigm of research

Sturmberg

2023

Evaluation Clinical Practice

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“…3 Equally, systems and complexity thinking fosters a view to understand the structure and function of things based on the interconnection and interactions amongst its building blocks (technically speaking, its agents) whereas reductionist thinking forces a view to understand the structure and function of a thing based on the study of its constituent parts. 4 Systems -regardless of being mechanical or living -are "whole[s] consisting of two or more parts (1) each of which can affect the performance or properties of the whole, (2) none of which can have an independent effect on the whole, and (3) no subgroup of which can have an independent effect on the whole." 5 In addition organisational systems require a focus to orientate themselves and to stay on track in a constantly changing environment if they truly want to achieve their purpose and goals.…”

Section: Systems and Complexity Thinking -A Different Way Of Seeing Tmentioning

confidence: 99%

Without Systems and Complexity Thinking There Is no Progress - or Why Bureaucracy Needs to Become Curious Comment on "What Can Policy-Makers Get out of Systems Thinking? Policy Partners’ Experiences of a Systems-Focused Research Collaboration in Preventive Health"

Sturmberg

2020

Int J Health Policy Manag

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The bureaucracy’s goal is to maintain uniformity and control within discrete areas of activity and relies on hierarchical processes and procedural correctness as means to suppress autonomous decision making. That worldview, however, is unsuited for problem solving of real world VUCA (Volatility, uncertainty, complexity and ambiguity) problems. Solving wicked problems in the VUCA world requires curiosity, creativity and collaboration, and a willingness to deeply engage and an ability to painstakingly work through their seemingly contradictory and chaotic pathways. In addition, it necessitates leadership. Leaders require a deep – indeed academic – understanding of the nature of the problems and the veracity of various problem-solving approaches. Leadership after all means "[facilitating] the necessary adaptive work that needs to be done by the people connected to the problem." That are the people at the coalface who understand and have to manage the complexities relating to problems unique to their local environment for which of the shelf solutions never work. Systems and complexity thinking is more than a tool, it is – in a sense – a way of being, namely deeply interested in understanding the highly interconnected and interdependent nature of the issues affecting our life and work. Hence, system and complexity thinking is, contrary to what Haynes and colleagues state in their "summation for the public reader," neither "overwhelming and hard [nor difficult] to use practically." Such a view is as much misleading as selfdefeating.

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If You Change the Way You Look at Things, Things You Look at Change. Max Planck’s Challenge for Health, Health Care, and the Healthcare System

Cited by 6 publications

References 133 publications

Making morbidity multiple: History, legacies, and possibilities for global health

Making morbidity multiple: History, legacies, and possibilities for global health

Changing the paradigm of research

Without Systems and Complexity Thinking There Is no Progress - or Why Bureaucracy Needs to Become Curious Comment on "What Can Policy-Makers Get out of Systems Thinking? Policy Partners’ Experiences of a Systems-Focused Research Collaboration in Preventive Health"

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